Working for the Government as a Nurse

Contrary to popular belief, nurses don’t solely work in health care facilities. In fact, with their specific experience, they can bring quite a lot to many other types of positions—including the government.

Mary M. Martin, PhD, APRN, CS, while now a Contributing
Faculty member at Walden University’s Doctor
of Nursing Practice (DNP) program, is also a Colonel in the U.S. Air Force,
and she worked from 1997-2005 as the Air Force Reserve Medical Director at US Air Force Pentagon Office of the Chief, Air Force
Reserve.

Have you ever wondered how this type of government position works? Martin took time to answer our questions about it.

How did you
obtain your position? Did you apply? Were you appointed?

Prior to my appointment,
this position had only been held by physicians. The Chief of the Air Force
Reserve decided that a nurse with a PhD at the rank of Colonel would be better
for this position since nursing education provides a broader academic
perspective and emphasizes the ability to collaborate and advocate. I was
nominated by a former supervisor and then vetted by the Command Surgeon and the
Chief, Air Force Reserve. At the time, there were only about 50 nurses with
doctorates in the entire Air Force Reserve.

My prior experience
leading up to this point had included commanding two Air Force Reserve
aeromedical evacuation units, serving as chief nurse in an aeromedical evacuation
group, and a deployment to Spain during Operation Desert Storm.

What did you
do while in that position? What were your most crucial responsibilities?

I supervised a
small staff of policy analysts consisting of medical administrators, physicians,
and experienced senior enlisted advisors. I collaborated with other branches of
the armed services to negotiate for changes in the medical and dental insurance
coverage for members of the armed forces and their families. I also responded
to complaints about medical and health issues sent by members of the Air Force
Reserve and their families to the Secretary of the Air Force, the White House,
and Congress.

My most crucial
responsibilities were representing the Air Force Reserve’s unique needs in policy
interpretation and advocacy involving all the U.S. Armed Forces or the larger
U.S. government. Standards for medical and dental care for military personnel are
established by law, so it was important for me to understand and communicate
the reserve component’s priorities when advocating for changes.

As a nurse,
what did you bring to the table that other people or other health care
providers didn’t? Why do you believe it was important to have a nurse involved
in this work?

Nursing education
embeds the role of advocacy throughout all levels of educational preparation. Nurses
are coached throughout their academic and clinical experiences to listen
carefully and objectively before taking a position. We also spend a great deal of
time learning the science of health care and nursing using systematic
processes. Despite our expertise, nurses also take an egalitarian approach in
discussions and decision making and don’t assume that others should accept our
point of view just because of our credentials.

What were some
of your greatest challenges in this position?

The greatest challenges
came while negotiating for solutions with powerful groups of colleagues from
all branches of the armed services. Each branch of the armed forces has its own
unique roles and challenges in managing the health and welfare of its members
and their families. I didn’t understand that fully until I was in a position to
negotiate on things like family medical and dental coverage or the
implementation of anthrax vaccination.

One particularly
challenging example: I was the sole Air Force Reserve representative on an interprofessional
team charged with resolving a conflict with line of duty determinations for
reservists not on active duty for more than 30 days. This case was in response
to a situation with a young pilot who suffered devastating injuries in a plane
crash while on his 14-day annual tour. He lost his regular job and insurance
and, because of legal restrictions on coverage for reservists on active duty
for less than 30 days, the military could not provide ongoing care or salary
after his initial treatment. The committee was led by Mary Lou Keener, a
nurse-attorney and presidential nominee who previously had been general counsel
for the Veterans Administration. It took us six months to reach a solution.

What were the
greatest rewards?

It was very
rewarding to be able to directly serve the men and women of the armed forces by
being able to advocate on their behalf to the Department of Defense, the White
House, and Congress. Knowing that I could work closely with powerful
institutions and people to help improve the health and welfare of our members
and their families was very satisfying.

If nurses
reading this want to become involved in government or as an elected official, what
would you say to them? Why is it important for nurses to become involved at
this level?

I would say to do
it! You can get started by applying your own experience to things you see
happening in your own community. I won the Charleston Post and Courier’s Golden
Pen award by simply reacting to a news article that stated that two young teens
lost at sea and found after a week or so would “fully recover.” The letter I
wrote spoke to the emotional trauma they experienced and how important it is to
address it early. I related it to my own experience as an eyewitness to the
attack on the Pentagon on 9/11 and what it has taken to ensure that my reactions
to this traumatic event remain resolved.

I would recommend that people look at the social determinants of health in your city. Are the sidewalks walkable in all neighborhoods? Are your local schools empowered to monitor and implement enough daily activity to improve both health and learning? How is your community addressing the opioid crisis or vaping? Then, find an example of a successful solution in another community and give your local decision makers a call. Offer to help! Finally, run for office locally. The rewards are great and, as nurses, we know how to get things done!

Is there
anything else about being a nurse working in government that I haven’t asked and
you think is important for people to know?

Yes! When I was
at the Pentagon, people I didn’t know working elsewhere in the building often
sought me out for personal advice on their health matters, especially
insurance. After all, nurses are our community’s best neighbors and news travels
fast when we join an organization. People know we will graciously respond to
their questions.